The Truth About Psych Meds…
…based on my clinical experience as a naturopathic doctor specializing in mental health.
Naturopathic doctors aren’t able to prescribe in every state, though in the state of Oregon, I am licensed and able to prescribe most medications.
Because I am a naturopath, I come at mental health and medication management from a slightly different perspective. While yes, I do prescribe, I also do a lot of health coaching with folks — how to eat better, sleep better, move more, engage in community in ways that are meaningful..
We each get to decide for ourselves how we respond to life and the world around us.
Ultimately, when medications support someone’s ability to do that, hooray! Let’s use them well.
Medications sometimes don’t help, or even hinder someone’s ability to have autonomy and be self directed… in which case, leave them out.
Meds work beautifully for some folks…
And at times, are critical.
Depending on the acuity and severity of mental illness, medication can be a lifeline.
With the right medication, over time, symptoms ease, and folks feel worlds better. Feeling better, they are, of course, able to work more easily, engage in relationships, go to therapy, eat better, move more. The quality of their health and life improves, tremendously.
Sometimes the first one works great… often it doesn’t.
The first medication trial (in depression) will help someone achieve remission approximately 30% of the time. This number goes up with subsequent trials, with approximately 70% of folks achieving remission with their third medication trial.
While the odds of finding an effective medication improve over time, often it takes many months of trialing different doses, different medications, and/or a combination of medications to find what works.
Insurance often dictates treatment.
Self explanatory?
If insurance won’t cover a medication, even if I as the prescriber think it is the best treatment option, 9.5 times of 10 the patient won’t get that medication because the out of pocket cost is too great.
This isn’t just medication, of course… if you’ve been sick in the US, you’ve likely run across this issue at one time or other.
Medications won’t fix or heal you.
This is nuanced. There are a handful of folks with severe and persistent mental illness who need medication. We could argue about our culture and the causes of illnesses like severe schizophrenia or bipolar disorder, etc, but the fact remains that in the time and place we live, medications often help folks to have a higher quality of life and participate as contributing members of society.
For some folks, medication is a more economical and convenient option. It’s far easier (and often cheaper) to pop a pill than to make sure you’re
getting enough protein
drinking enough water
getting exercise for at least 30 min five times per week
engaging with other people in a meaningful way…
Medication can absolutely be a stopgap, or a support to help folks do these things. Someone crippled by social anxiety will likely be able to engage socially if their anxiety is treated. If someone is depressed and has no energy or motivation to go for a walk or grocery shop, the right medication can help get their legs under them so that they can go do those things and get those foundational habits established.
But medications often don’t address the root cause of the issue someone is experiencing. It’s a bandaid over symptoms of mental illness.
You can take meds all day every day, but best outcomes happen when YOU take ownership of your health.
This goes with my last point. People often expect medications will be the thing that makes them better. And yes, certainly they can help. There are a rare few folks who come in, the medication hits just right, and they’re good to go.
More commonly, folks see some improvement if they start medications. They see miles more improvement when they start eating properly, drinking water, exercising, sleeping, engaging in social media mindfully, setting good boundaries, engaging in the right kind of therapy…
As a prescriber, I can (and do) coach folks through these habit changes, but they’re not coming from out of a pill bottle. They require sustained, consistent effort.
To heal, you have to feel the things.
While there are moments we do need to compartmentalize, emotions have to be felt at some point. You can’t medication your way out of feeling your feelings.
This is why medication and therapy go together, ideally.
When medication is used well, it helps to create more space for someone to engage in therapy so that they can more fully process their emotions. It grants increased latitude for someone to be able to practice skills to help them cope with difficult situations and emotions, so that they can address the root of their symptoms.
There’s a place for natural products and supplements.
And safety matters.
And interactions can be potentially dangerous.
Just because a product is ‘natural’ does not mean it is safe. Just because you can buy something over the counter, doesn’t mean it’s a good product for you.
Rhodiola, for example, is contraindicated for folks who have bipolar disorder, as it has been implicated in pushing mania.
St John’s Wort, while lovely for depression, interacts with all kinds of medications and can cause both safety and efficacy concerns if taken with other medications.
5-HTP (tryptophan) can interact with other medications that affect serotonin metabolism and contribute to possible serotonin syndrome, a potential life threatening condition.
This is not an exhaustive list.
There’s no one size fits all treatment plan; some medications work for some folks, others don’t. Some people don’t want to touch a prescription med with a ten foot pole, others are ok with it.
All in all, whatever helps ease suffering and improves your ability to embrace your inner knowing is the best way to go!
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Note: This post is intended for information and entertainment purposes only; nothing in this article or episode is a substitute for medical or mental health treatment; do not delay necessary medical care; please work with a qualified and licensed health care provider in your area.
